Ocular manifestations of occupational exposure to corticosteroids in the pharmaceutical industry

Abstract

The therapeutic use of corticosteroids has long been associated with ocular side effects such as the development of cataracts, glaucoma, and retinal and choroidal emboli. This study was conducted to assess ocular disorders, which may occur in workers engaged in manufacturing corticosteroids in the pharmaceutical industry. The study population included 58 workers involved in the manufacturing of corticosteroid preparations. They were subdivided according to duration of exposure into 2 groups: Gr. I of <15 years duration of employment and Gr. II of 15 + years duration of employment. Methods included answering a structured questionnaire enquiring about occupational and medical histories, full ocular and clinical examination, and measurement of certain biochemical parameters, such as plasma cortisol, serum total cholesterol, serum triglycerides, fasting blood sugar and serum calcium. Results showed that 25 cataracts were diagnosed in the studied group with a rate of 21.55 per one hundred eyes. Of Gr.II, 43.75% of eyes had cataracts compared to 5.88% of Gr.I. Odds ratio to develop cataracts was 12.44 for Gr. II compared to Gr.I. Ocular hypertension and open-angle glaucoma were present in 25.00% of the eyes of the studied groups with odds of 5.83 times more when being employed for 15 or more years. Significant +ve correlation was found between intraocular pressure and relevant biochemical parameters. In the present study, a clear relationship was detected between the length of the period of exposure to corticosteroids as environmental pollutants and the development of ocular medical disorders such as cataracts, ocular hypertension and glaucoma. Further research work is needed to study the effects of exposure to corticosteroids as pollutants in the work environment, gaining access into body via unusual routes of entry, and for periods of time not reported in the therapeutic literature.